Bridging the Global Digital Health Divide for Cardiovascular Disease.

Abstract

Big data approaches have been lauded as game changers in health care. Exponential growth of telecommunications and mobile phone ownership have presented new possibilities for digital health (use of data to drive health care), e-health (use of electronic processes in health care), and m-health (use of mobile technologies in health care). From machine learning and natural language processing to genomics and metabolomics, advanced analytics are being developed to improve health outcomes. Health inequalities are well documented within and across countries, and the role of social determinants is increasingly recognized as an important factor driving these differences. Could digital technologies and their associated healthcare strategies improve these health inequalities by making information and expertise more scalable and widely available? Or will they perpetuate or even worsen these widespread differences? Cardiovascular diseases (CVD), the cause of greatest morbidity and mortality worldwide, are the ideal lens through which to explore these issues and the future of global health in the era of digital health. According to the GBD study (Global Burden of Disease),1 which celebrated its 20th anniversary in October, CVD disproportionately affects low- and middle-income countries (LMICs), but technologies are widely transforming societal trends across many LMICs. In this article, the potential associations between digital health and inequalities in CVD are reviewed. There have been several calls for greater attention and action for the CVD epidemic, recognizing the disparities between countries and within countries at every stage of the patient journey. In terms of diagnosis, individuals from lower socioeconomic status and from LMICs have less access to screening programs and testing, whether laboratory, imaging, or interventional-based. Preventive strategies, from lifestyle to medical interventions, are less likely to be implemented in these settings. Evidence-based treatment, including drugs and invasive therapies such as surgery, are less widely available and less likely to be …